HYBRID EVENT: You can participate in person at Madrid, Spain or Virtually from your home or work.

5th Edition of Global Conference on Surgery and Anaesthesia

September 05-07, 2024 | Hybrid Event

September 05 -07, 2024 | Madrid, Spain
GCSA 2024

Acute large bowel obstruction post umbilical hernia surgery: A case report

Trung Nguyen Dang, Speaker at Surgery Conferences
California Health Sciences University, College of Osteopathic Medicine, United States
Title : Acute large bowel obstruction post umbilical hernia surgery: A case report

Abstract:

Large bowel obstruction (LBO) is a less common cause of bowel obstruction, but it has a broad range of differentials. The most common etiology in the United States is colorectal adenocarcinoma. Patient presentation includes diffuse abdominal pain, constipation, abdominal distension, and nausea. Abdominal X-rays can quickly assess bowel dilation, but CT scan is the gold standard to determine location and severity of blockage. Treatment can range from IV fluid to emergent colectomy. A 41-year-old male with history of bronchitis and hypertension presented for surgical consult six days post-incarcerated umbilical hernia repair. Patient complained of nausea, diffuse abdominal distension and tenderness, and inability to pass gas. Physical examination revealed severely distended abdomen with rebound and guarding at the lower right quadrant. CT scan showed severely dilated ascending colon and cecum along with pneumatosis. There was also an obstructing mass at the sigmoid colon. A diagnosis of severe LBO with impending perforation was made, and patient underwent emergent exploratory laparotomy. Subtotal colectomy was done with anastomosis between ileum and sigmoid colon. Pathology report showed an 8.0 cm dilated cecum, necrosis of ascending colon, and diverticulitis with scar fibrosis along the wall of colonic membrane. Patient had ileus and kidney injury post-operation but was resolved. Diverticulitis is historically common in elderly population, but recent studies showed increased incidence among younger population. It is a common cause of obstruction but rarely causes severe complications like pneumatosis and perforation that require emergent surgery. When occluded, the mass and patent ileocecal valve can cause closed-loop bowel syndrome. Even though unhealthy diet is known trigger for diverticulitis, surgery is possibly another rare factor. Patients of all ages should be educated on symptoms of diverticular disease, and surgical monitoring is needed in those with known diverticulosis.

Audience Take Away Notes:

  • Review the mechanism of closed-loop bowel syndrome and etiologies
  • Be aware of the increasing incidences of diverticulitis in population under 60 years old
  • Be aware that surgeries might be a rare cause of diverticulitis that can lead to severe large bowel obstruction
  • Be more vigilant on educating patients about diverticular diseases and risk factors that can prevent recurrent diverticulitis

Biography:

Trung Nguyen Dang is a 3rd year medical student from California Health Sciences University, College of Osteopathic Medicine (CHSU-COM). He is interested in general surgery with an interest in colorectal surgery. He served as the president of the Osteopathic Physicians and Surgeons of Califonia chapter at CHSU-COM. He has presented multiple research at many conferences, with a focus on learning and improving community health

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